Agency Information Collection Activities: Proposed Request and Comment Request, 47845-47848 [2016-17259]

Download as PDF ehiers on DSK5VPTVN1PROD with NOTICES Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices that there is a lack of current and accurate information concerning the securities of Scanner Technologies Corp. (‘‘SCNI 1’’) (CIK No. 217222), a revoked New Mexico corporation located in Minneapolis, Minnesota with a class of securities registered with the Commission pursuant to Securities Exchange Act of 1934 (‘‘Exchange Act’’) Section 12(g) because it is delinquent in its periodic filings with the Commission, having not filed any periodic reports since it filed a Form 10–Q for the period ended September 30, 2008. On January 29, 2016, the Commission’s Division of Corporation Finance (‘‘Corporation Finance’’) sent a delinquency letter to SCNI requesting compliance with its periodic filing requirements but SCNI did not receive the delinquency letter due to its failure to maintain a valid address on file with the Commission as required by Commission rules (Rule 301 of Regulation S–T, 17 CFR 232.301 and Section 5.4 of EDGAR Filer Manual) (‘‘Commission Issuer Address Rules’’). As of July 14, 2016, the common stock of SCNI was quoted on OTC Link operated by OTC Markets Group Inc. (formerly ‘‘Pink Sheets’’) (‘‘OTC Link’’), had four market makers, and was eligible for the ‘‘piggyback’’ exception of Exchange Act Rule 15c2–11(f)(3). It appears to the Commission that there is a lack of current and accurate information concerning the securities of Seville Ventures Corp. (‘‘SVLE’’) (CIK No. 1527424), a revoked Nevada corporation located in Byron, Illinois with a class of securities registered with the Commission pursuant to Exchange Act Section 12(g) because it is delinquent in its periodic filings with the Commission, having not filed any periodic reports since it filed a Form 10–Q for the period ended April 30, 2014. On October 19, 2015, Corporation Finance sent a delinquency letter to SVLE requesting compliance with its periodic filing requirements but SVLE did not receive the delinquency letter due to its failure to maintain a valid address on file with the Commission as required by Commission Issuer Address Rules. As of July 14, 2016, the common stock of SVLE was quoted on OTC Link, had one market makers, and was eligible for the ‘‘piggyback’’ exception of Exchange Act Rule 15c2–11(f)(3). It appears to the Commission that there is a lack of current and accurate information concerning the securities of StarInvest Group, Inc. (‘‘STIV’’) (CIK No. 810270), a revoked Nevada corporation located in Long Beach, New York with 1 The short form of each issuer’s name is also its stock symbol. VerDate Sep<11>2014 15:19 Jul 21, 2016 Jkt 238001 a class of securities registered with the Commission pursuant to Exchange Act Section 12(g) because it is delinquent in its periodic filings with the Commission, having not filed any periodic reports since it filed a Form 10–K for the period ended December 31, 2010. On March 3, 2014, Corporation Finance sent a delinquency letter to STIV requesting compliance with its periodic filing requirements but STIV did not receive the delinquency letter due to its failure to maintain a valid address on file with the Commission as required by Commission Issuer Address Rules. As of July 14, 2016, the common stock of STIV was quoted on OTC Link, had five market makers, and was eligible for the ‘‘piggyback’’ exception of Exchange Act Rule 15c2–11(f)(3). It appears to the Commission that there is a lack of current and accurate information concerning the securities of The Digital Development Group Corp. (‘‘DIDG’’) (CIK No. 1379699), a Nevada corporation located in Los Angeles, California with a class of securities registered with the Commission pursuant to Exchange Act Section 12(g) because it is delinquent in its periodic filings with the Commission, having not filed any periodic reports since it filed a Form 10–Q for the period ended September 30, 2014. On November 30, 2015, Corporation Finance sent a delinquency letter to DIDG requesting compliance with its periodic filing requirements but DIDG did not receive the delinquency letter due to its failure to maintain a valid address on file with the Commission as required by Commission Issuer Address Rules. As of July 14, 2016, the common stock of DIDG was quoted on OTC Link, had five market makers, and was eligible for the ‘‘piggyback’’ exception of Exchange Act Rule 15c2–11(f)(3). The Commission is of the opinion that the public interest and the protection of investors require a suspension of trading in the securities of the above-listed companies. Therefore, it is ordered, pursuant to Section 12(k) of the Securities Exchange Act of 1934, that trading in the securities of the abovelisted companies is suspended for the period from 9:30 a.m. EDT on July 20, 2016, through 11:59 p.m. EDT on August 2, 2016. By the Commission. Jill M. Peterson, Assistant Secretary. [FR Doc. 2016–17449 Filed 7–20–16; 11:15 am] BILLING CODE 8011–01–P PO 00000 Frm 00100 Fmt 4703 Sfmt 4703 47845 SMALL BUSINESS ADMINISTRATION Harbert Mezzanine Partners II SBIC, L.P., License No. 04/04–0298; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Harbert Mezzanine Partners II SBIC, L.P., 2100 Third Avenue North, Suite 600, Birmingham, AL 35203, a Federal Licensee under the Small Business Investment Act of 1958, as amended (‘‘the Act’’), in connection with the financing of CDA, Inc., 8500 South Tyron Street, Charlotte, NC 28273, has sought an exemption under Section 312 of the Act and 13 CFR 107.730 financings which constitute conflicts of interest of the Small Business Administration (‘‘SBA’’) Rules and Regulations. Harbert Mezzanine Partners II SBIC, L.P. proposes to provide debt financing to CDA, Inc., owned by Harbinger Mezzanine Partners, L.P., an associate as defined in 13 CFR 107.50 of the SBA Rules and Regulations. Therefore this transaction is considered a conflict of interest requiring SBA’s prior written exemption. Notice is hereby given that any interested person may submit written comments on the transaction, within fifteen days of the date of this publication, to the Associate Administrator for Investment, U.S. Small Business Administration, 409 Third Street SW., Washington, DC 20416. Mark Walsh, Associate Administrator, Office of Investment and Innovation. [FR Doc. 2016–17317 Filed 7–21–16; 8:45 am] BILLING CODE P SOCIAL SECURITY ADMINISTRATION [Docket No: SSA–2016–0033] Agency Information Collection Activities: Proposed Request and Comment Request The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104–13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions and one extension of OMB-approved information collections. SSA is soliciting comments on the accuracy of the agency’s burden estimate; the need for the information; E:\FR\FM\22JYN1.SGM 22JYN1 47846 Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices its practical utility; ways to enhance its quality, utility, and clarity; and ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers. (OMB); Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 202–395–6974, Email address: OIRA_Submission@omb.eop.gov (SSA); Social Security Administration, OLCA, Attn: Reports Clearance Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–966–2830, Email address: OR.Reports.Clearance@ssa.gov Or you may submit your comments online through www.regulations.gov, referencing Docket ID Number [SSA– 2016–0033]. I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than September 20, 2016. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Request for Hearing by Administrative Law Judge—20 CFR 404.929, 404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722—0960– 0269. When SSA denies applicants’ or beneficiaries’ requests for new or continuing benefits, the Social Security Act entitles those applicants or beneficiaries to request a hearing to appeal the decision. To request a hearing, individuals complete Form HA–501, the associated Modernized Claims System (MCS) or Modernized Supplemental Security Income Claims System (MSSICS) interview, or the Internet application (i501). SSA uses the Number of respondents Modality of completion information to determine if the individual: (1) Filed the request within the prescribed time; (2) is the proper party; and (3) took the steps necessary to obtain the right to a hearing. SSA also uses the information to determine: (1) The individual’s reason(s) for disagreeing with SSA’s prior determinations in the case; (2) if the individual has additional evidence to submit; (3) if the individual wants an oral hearing or a decision on the record; and (4) whether the individual has (or wants to appoint) a representative. The respondents are Social Security benefit applicants and recipients who want to appeal SSA’s denial of their request for new or continued benefits, and Medicare Part B recipients who must pay the Medicare Part B Income-Related Monthly Adjustment Amount. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) HA–501; Modernized Claims System (MCS); Modernized Supplemental Security Income Claims System (MSSICS) ..................................................... I501 (Internet iAppeals) ................................................................................... 25,953 643,516 1 1 10 5 4,326 53,626 Totals ........................................................................................................ 669,469 ........................ ........................ 57,952 2. Travel Expense Reimbursement— 20 CFR 404.999(d) and 416.1499— 0960–0434. The Social Security Act provides for travel expense reimbursement from Federal and State agencies for claimant travel incidental to medical examinations, and to parties, their representatives, and all reasonably necessary witnesses for travel exceeding 75 miles to attend medical examinations, reconsideration interviews and proceedings before an administrative law judge. Reimbursement procedures require the claimant to provide: (1) A list of expenses incurred, and (2) receipts of such expenses. Federal and state personnel review the listings and receipts to verify the reimbursable amount to the requestor. The respondents are claimants for Title II benefits and Title XVI payments, their representatives, and witnesses. Type of Request: Extension of an OMB-approved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 404.99(d) & 416.1499 ...................................................................................... 60,000 1 10 10,000 ehiers on DSK5VPTVN1PROD with NOTICES 3. Request for Reconsideration—20 CFR 404.907–404.921, 416.1407– 416.1421, 408.1009, and 418.1325— 0960–0622. Individuals use Form SSA– 561–U2, the associated MCS interview, or the Internet application (i561) to initiate a request for reconsideration of a denied claim. SSA uses the information to document the request and to determine an individual’s eligibility or entitlement to Social Security benefits (Title II), SSI payments (Title XVI), Special Veterans Benefits (Title VIII), Medicare (Title XVIII), and Number of respondents Modality of completion SSA–561 and Modernized Claims System (MCS) .......................................... VerDate Sep<11>2014 15:19 Jul 21, 2016 Jkt 238001 PO 00000 Frm 00101 Fmt 4703 Sfmt 4703 for initial determinations regarding Medicare Part B income-related premium subsidy reductions. The respondents are individuals filing for reconsideration of a denied claim. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response 550,370 E:\FR\FM\22JYN1.SGM 1 22JYN1 Estimated total annual burden (hours) 8 73,383 47847 Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) I561 (Internet iAppeals) ................................................................................... 911,330 1 5 75,944 Totals ........................................................................................................ 1,461,700 ........................ ........................ 149,327 II. SSA submitted the information collections below to OMB for clearance. Your comments regarding the information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than August 22, 2016 Individuals can obtain copies of the OMB clearance package by writing to OR.Reports.Clearance@ ssa.gov. 1. Application for Supplemental Security Income—20 CFR 416.207 and 416.305–416.335, Subpart C—0960– 0229. The Supplemental Security Income (SSI) program provides aged, blind, and disabled individuals who have little or no income, with funds for food, clothing, and shelter. Individuals complete Form SSA–8000–BK to apply Number of respondents Modality of completion for SSI. SSA uses the information from Form SSA–8000–BK and its electronic intranet counterpart, MSSICS, to determine: (1) Whether SSI claimants meet all statutory and regulatory eligibility requirements; and (2) SSI payment amounts. The respondents are applicants for SSI or their representative payees. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) SSA–8000–BK (Paper Version) ...................................................................... MSSICS/Signature Proxy ................................................................................ 17,541 1,373,401 1 1 41 35 11,986 801,151 Totals ........................................................................................................ 1,390,942 ........................ ........................ 813,137 2. Medical Application for Supplemental Security Income—20 CFR 416.305–416.335, Subpart C—0960– 0444. SSA uses Form SSA–8001–BK to determine an applicant’s eligibility for SSI and SSI payment amounts. SSA employees also collect this information during interviews with members of the public who wish to file for SSI. SSA uses the information for two purposes: (1) To formally deny SSI for nonmedical reasons when information the applicant provides results in ineligibility; or (2) to establish a Number of responses Modality of completion disability claim, but defer the complete development of non-medical issues until SSA approves the disability. The respondents are applicants for SSI. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) MSSICS/Signature Proxy ................................................................................ Non-MSSICS (Paper) ...................................................................................... 937,207 1,033 1 1 20 20 312,402 344 Totals ........................................................................................................ 938,240 ........................ ........................ 312,746 ehiers on DSK5VPTVN1PROD with NOTICES 3. Function Report—Child (Birth to 1st Birthday, Age 1 to 3rd Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th Birthday)—20 CFR 416.912 and 416.924a(a)(2)—0960– 0542. As part of SSA’s disability determination process, we use Forms SSA–3375–BK through SSA–3379–BK to request information from a child’s parent or guardian for children applying for SSI. The five different versions of the form contain questions about the child’s day-to-day functioning appropriate to a particular age group; thus, respondents use only one version of the form for each child. The adjudicative team (disability examiners and medical or psychological consultants) of State disability determination services offices collect the information on the appropriate version of this form (in conjunction with medical and other evidence) to form a complete picture of the children’s ability to function and their impairment-related limitations. The adjudicative team uses the completed profile to determine: (1) If each child’s impairment(s) results in marked and severe functional limitations; and (2) whether each child is disabled. The respondents are parents and guardians of child applicants for SSI. Type of Request: Revision on an OMB-approved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–3375; SSA-3376; SSA-3377; SSA-3378; SSA–3379 ............................. 532,000 1 20 177,333 VerDate Sep<11>2014 15:19 Jul 21, 2016 Jkt 238001 PO 00000 Frm 00102 Fmt 4703 Sfmt 4703 E:\FR\FM\22JYN1.SGM 22JYN1 47848 Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices 4. Government-to-Government Services Online Web site Registration; Government-to-Government Services Online Web site Account Modification/ Deletion Form—20 CFR 401.45—0960– 0757. The Government-to-Government Services Online (GSO) Web site allows various external organizations to submit files to a variety of SSA systems and, in some cases, receive files in return. The SSA systems that process data transferred via GSO include, but are not limited to, systems responsible for disability processing and benefit determination or termination. SSA uses the information on Form SSA–159, Government-to-Government Online Web site Registration Form, to register the requestor to use the GSO Web site. Once we receive the SSA–159, SSA provides the user with account information and conducts a walkthrough of the GSO Web site as necessary. Established organizations may submit Form SSA– Number of respondents Modality of completion 159 to register additional users as well. The established requesting organizations can also complete Form SSA–160, Government-to-Government Online Web site Account Modification/ Deletion Form, to modify their online accounts (e.g., address change). Respondents are State and local government agencies, and some private sector business entities. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) SSA–159 .......................................................................................................... SSA–160 .......................................................................................................... 1,543 130 1 1 15 15 386 33 Totals ........................................................................................................ 1,673 ........................ ........................ 419 Dated: July 18, 2016. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. interest. I have ordered that Public Notice of these Determinations be published in the Federal Register. BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice: 9648] Culturally Significant Objects Imported for Exhibition Determinations: ‘‘Every People Under Heaven: Jerusalem, 1000–1400’’ Exhibition Notice is hereby given of the following determinations: Pursuant to the authority vested in me by the Act of October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and Restructuring Act of 1998 (112 Stat. 2681, et seq.; 22 U.S.C. 6501 note, et seq.), Delegation of Authority No. 234 of October 1, 1999, Delegation of Authority No. 236–3 of August 28, 2000 (and, as appropriate, Delegation of Authority No. 257–1 of December 11, 2015), I hereby determine that the objects to be included in the exhibition ‘‘Every People Under Heaven: Jerusalem, 1000– 1400,’’ imported from abroad for temporary exhibition within the United States, are of cultural significance. The objects are imported pursuant to loan agreements with the foreign owners or custodians. I also determine that the exhibition or display of the exhibit objects at The Metropolitan Museum of Art, New York, New York, from on about September 20, 2016, until on or about January 8, 2017, and at possible additional exhibitions or venues yet to be determined, is in the national ehiers on DSK5VPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 15:19 Jul 21, 2016 Jkt 238001 For further information, including a list of the imported objects, contact the Office of Public Diplomacy and Public Affairs in the Office of the Legal Adviser, U.S. Department of State (telephone: 202– 632–6471; email: section2459@ state.gov). The mailing address is U.S. Department of State, L/PD, SA–5, Suite 5H03, Washington, DC 20522–0505. FOR FURTHER INFORMATION CONTACT: [FR Doc. 2016–17259 Filed 7–21–16; 8:45 am] Dated: July 14, 2016. Mark Taplin, Deputy Assistant Secretary for Policy, Bureau of Educational and Cultural Affairs, Department of State. [FR Doc. 2016–17395 Filed 7–21–16; 8:45 am] BILLING CODE 4710–05–P DEPARTMENT OF STATE [Public Notice: 9647] Culturally Significant Objects Imported for Exhibition Determinations: ‘‘Breaking News: Turning the Lens on Mass Media’’ Exhibition Notice is hereby given of the following determinations: Pursuant to the authority vested in me by the Act of October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and Restructuring Act of 1998 (112 Stat. 2681, et seq.; 22 U.S.C. 6501 note, et seq.), Delegation of Authority No. 234 of October 1, 1999, Delegation of Authority No. 236–3 of August 28, 2000 (and, as appropriate, Delegation of Authority No. 257 of April 15, 2003), I hereby determine that the objects to be included in the exhibition ‘‘Breaking SUMMARY: PO 00000 Frm 00103 Fmt 4703 Sfmt 9990 News: Turning the Lens on Mass Media,’’ imported from abroad for temporary exhibition within the United States, are of cultural significance. The objects are imported pursuant to loan agreements with the foreign owners or custodians. I also determine that the exhibition or display of the exhibit objects at the J. Paul Getty Museum at the Getty Center, Los Angeles, California, from on or about December 20, 2016, until on or about April 30, 2017, and at possible additional exhibitions or venues yet to be determined, is in the national interest. I have ordered that Public Notice of these Determinations be published in the Federal Register. For further information, including a list of the imported objects, contact the Office of Public Diplomacy and Public Affairs in the Office of the Legal Adviser, U.S. Department of State (telephone: 202– 632–6471; email: section2459@ state.gov). The mailing address is U.S. Department of State, L/PD, SA–5, Suite 5H03, Washington, DC 20522–0505. FOR FURTHER INFORMATION CONTACT: Dated: July 13, 2016. Mark Taplin, Principal Deputy Assistant Secretary, Bureau of Educational and Cultural Affairs, Department of State. [FR Doc. 2016–17396 Filed 7–21–16; 8:45 am] BILLING CODE 4710–05–P E:\FR\FM\22JYN1.SGM 22JYN1

Agencies

[Federal Register Volume 81, Number 141 (Friday, July 22, 2016)]
[Notices]
[Pages 47845-47848]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-17259]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0033]


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions and one extension of OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information;

[[Page 47846]]

its practical utility; ways to enhance its quality, utility, and 
clarity; and ways to minimize burden on respondents, including the use 
of automated collection techniques or other forms of information 
technology. Mail, email, or fax your comments and recommendations on 
the information collection(s) to the OMB Desk Officer and SSA Reports 
Clearance Officer at the following addresses or fax numbers.

(OMB); Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, Email address: OIRA_Submission@omb.eop.gov
(SSA); Social Security Administration, OLCA, Attn: Reports Clearance 
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-966-2830, Email address: OR.Reports.Clearance@ssa.gov

Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2016-0033].
    I. The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than 
September 20, 2016. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722--0960-0269. 
When SSA denies applicants' or beneficiaries' requests for new or 
continuing benefits, the Social Security Act entitles those applicants 
or beneficiaries to request a hearing to appeal the decision. To 
request a hearing, individuals complete Form HA-501, the associated 
Modernized Claims System (MCS) or Modernized Supplemental Security 
Income Claims System (MSSICS) interview, or the Internet application 
(i501). SSA uses the information to determine if the individual: (1) 
Filed the request within the prescribed time; (2) is the proper party; 
and (3) took the steps necessary to obtain the right to a hearing. SSA 
also uses the information to determine: (1) The individual's reason(s) 
for disagreeing with SSA's prior determinations in the case; (2) if the 
individual has additional evidence to submit; (3) if the individual 
wants an oral hearing or a decision on the record; and (4) whether the 
individual has (or wants to appoint) a representative. The respondents 
are Social Security benefit applicants and recipients who want to 
appeal SSA's denial of their request for new or continued benefits, and 
Medicare Part B recipients who must pay the Medicare Part B Income-
Related Monthly Adjustment Amount.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-501; Modernized Claims System (MCS);                   25,953               1              10           4,326
 Modernized Supplemental Security Income Claims
 System (MSSICS)................................
I501 (Internet iAppeals)........................         643,516               1               5          53,626
                                                 ---------------------------------------------------------------
    Totals......................................         669,469  ..............  ..............          57,952
----------------------------------------------------------------------------------------------------------------

    2. Travel Expense Reimbursement--20 CFR 404.999(d) and 416.1499--
0960-0434. The Social Security Act provides for travel expense 
reimbursement from Federal and State agencies for claimant travel 
incidental to medical examinations, and to parties, their 
representatives, and all reasonably necessary witnesses for travel 
exceeding 75 miles to attend medical examinations, reconsideration 
interviews and proceedings before an administrative law judge. 
Reimbursement procedures require the claimant to provide: (1) A list of 
expenses incurred, and (2) receipts of such expenses. Federal and state 
personnel review the listings and receipts to verify the reimbursable 
amount to the requestor. The respondents are claimants for Title II 
benefits and Title XVI payments, their representatives, and witnesses.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499........................          60,000                1               10           10,000
----------------------------------------------------------------------------------------------------------------

    3. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009, and 418.1325--0960-0622. Individuals use Form SSA-
561-U2, the associated MCS interview, or the Internet application 
(i561) to initiate a request for reconsideration of a denied claim. SSA 
uses the information to document the request and to determine an 
individual's eligibility or entitlement to Social Security benefits 
(Title II), SSI payments (Title XVI), Special Veterans Benefits (Title 
VIII), Medicare (Title XVIII), and for initial determinations regarding 
Medicare Part B income-related premium subsidy reductions. The 
respondents are individuals filing for reconsideration of a denied 
claim.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-561 and Modernized Claims System (MCS)......         550,370               1               8          73,383

[[Page 47847]]

 
I561 (Internet iAppeals)........................         911,330               1               5          75,944
                                                 ---------------------------------------------------------------
    Totals......................................       1,461,700  ..............  ..............         149,327
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding the information collections would be 
most useful if OMB and SSA receive them 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than August 22, 2016 Individuals can obtain copies of the OMB 
clearance package by writing to OR.Reports.Clearance@ssa.gov.
    1. Application for Supplemental Security Income--20 CFR 416.207 and 
416.305-416.335, Subpart C--0960-0229. The Supplemental Security Income 
(SSI) program provides aged, blind, and disabled individuals who have 
little or no income, with funds for food, clothing, and shelter. 
Individuals complete Form SSA-8000-BK to apply for SSI. SSA uses the 
information from Form SSA-8000-BK and its electronic intranet 
counterpart, MSSICS, to determine: (1) Whether SSI claimants meet all 
statutory and regulatory eligibility requirements; and (2) SSI payment 
amounts. The respondents are applicants for SSI or their representative 
payees.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8000-BK (Paper Version).....................          17,541               1              41          11,986
MSSICS/Signature Proxy..........................       1,373,401               1              35         801,151
                                                 ---------------------------------------------------------------
    Totals......................................       1,390,942  ..............  ..............         813,137
----------------------------------------------------------------------------------------------------------------

    2. Medical Application for Supplemental Security Income--20 CFR 
416.305-416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to 
determine an applicant's eligibility for SSI and SSI payment amounts. 
SSA employees also collect this information during interviews with 
members of the public who wish to file for SSI. SSA uses the 
information for two purposes: (1) To formally deny SSI for non-medical 
reasons when information the applicant provides results in 
ineligibility; or (2) to establish a disability claim, but defer the 
complete development of non-medical issues until SSA approves the 
disability. The respondents are applicants for SSI.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                     responses       response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS/Signature Proxy..........................         937,207               1              20         312,402
Non-MSSICS (Paper)..............................           1,033               1              20             344
                                                 ---------------------------------------------------------------
    Totals......................................         938,240  ..............  ..............         312,746
----------------------------------------------------------------------------------------------------------------

    3. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd 
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th 
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of 
SSA's disability determination process, we use Forms SSA-3375-BK 
through SSA-3379-BK to request information from a child's parent or 
guardian for children applying for SSI. The five different versions of 
the form contain questions about the child's day-to-day functioning 
appropriate to a particular age group; thus, respondents use only one 
version of the form for each child. The adjudicative team (disability 
examiners and medical or psychological consultants) of State disability 
determination services offices collect the information on the 
appropriate version of this form (in conjunction with medical and other 
evidence) to form a complete picture of the children's ability to 
function and their impairment-related limitations. The adjudicative 
team uses the completed profile to determine: (1) If each child's 
impairment(s) results in marked and severe functional limitations; and 
(2) whether each child is disabled. The respondents are parents and 
guardians of child applicants for SSI.
    Type of Request: Revision on an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3375; SSA[dash]3376; SSA[dash]3377;              532,000                1               20          177,333
 SSA[dash]3378; SSA-3379....................
----------------------------------------------------------------------------------------------------------------


[[Page 47848]]

    4. Government-to-Government Services Online Web site Registration; 
Government-to-Government Services Online Web site Account Modification/
Deletion Form--20 CFR 401.45--0960-0757. The Government-to-Government 
Services Online (GSO) Web site allows various external organizations to 
submit files to a variety of SSA systems and, in some cases, receive 
files in return. The SSA systems that process data transferred via GSO 
include, but are not limited to, systems responsible for disability 
processing and benefit determination or termination. SSA uses the 
information on Form SSA-159, Government-to-Government Online Web site 
Registration Form, to register the requestor to use the GSO Web site. 
Once we receive the SSA-159, SSA provides the user with account 
information and conducts a walkthrough of the GSO Web site as 
necessary. Established organizations may submit Form SSA-159 to 
register additional users as well. The established requesting 
organizations can also complete Form SSA-160, Government-to-Government 
Online Web site Account Modification/Deletion Form, to modify their 
online accounts (e.g., address change). Respondents are State and local 
government agencies, and some private sector business entities.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-159.........................................           1,543               1              15             386
SSA-160.........................................             130               1              15              33
                                                 ---------------------------------------------------------------
    Totals......................................           1,673  ..............  ..............             419
----------------------------------------------------------------------------------------------------------------


    Dated: July 18, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-17259 Filed 7-21-16; 8:45 am]
BILLING CODE 4191-02-P